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Home > Chapmans Reflexes

Category: Chapmans Reflexes

An image of a wrist in pain with laptop on the background and an Xray image of Shoulder bones
November 21, 2022 Paula Nutting

How to Effectively Relieve Shoulder and Wrist Pain

Are you suffering from shoulder or wrist pain? Are you getting relief from pain killers but are still not fully satisfied with the results? How do you relieve the pressure and pain in your shoulders and wrists? Shoulder and wrist discomfort is up there with those common complaints among my clients. Some people on a daily basis never get to experience shoulder or wrist pain others with bad conditions suffer from extreme pain during the course of their daily activities. When you’re involved in physical activity, your muscles may be overused or misused causing sharp pains that radiate down your arm. Shoulder and wrist pain can also result from an accident or simply from stress. Fortunately, there are several effective ways to reduce your pain and get back to normal as quickly as possible.

Types of Shoulder and Wrist Pain

There are several types of shoulder and wrist pains, as well as the specific pain associated with each type. 

  • Dislocated Shoulder - This occurs when the humerus (the “arm bone”) comes out of the shoulder socket. However nasty this sounds, most people with a dislocated shoulder have very little actual pain. The pain occurs when the rapid dislocation occurs and that is to the muscles, ligaments and nerves that are stretched/torn in the incident. If you do have a dislocation you will notice the pain when movement is attempted. Surgical repair is the only proven treatment. 
  • Degenerative Shoulder - This is the most common type of shoulder pain. It is caused by degeneration, which is the normal ageing process of the joints. As joints become less flexible, they tend to wear down and harden. This, in turn, can lead to shoulder pain. Surgical repair is the only proven treatment. 
  • Rib Popping - This is the result of overuse or repetitive movement. It may occur due to an over stretched or damaged muscle. It is often accompanied by sharp, shooting pain. It is often painful and can last from days to weeks. Movement of the torso on any rib attachment will be painful till the rib cartilage repairs. 
  • Rib Fracture - This occurs when a rib snaps or is dislocated. In between each rib is its associated intercostal nerve, the artery and veins that supply blood supply to the area. The ribs are designed to guard organs beneath and the thoracic cavity has a variety of structures. It is usually accompanied by a sudden, shooting pain. 
  • Tendinopathy - Tendons, which are rope-like tissue that connect your bones and muscles. It can occur when you overuse or injure a tendon. Tendinopathy can be chronic but your symptoms will improve with physical therapy and rest.
  • Rotator cuff tears - Adults who experience shoulder pain and disability commonly develop this. Your shoulder could become weak if your rotator cuff is torn. The supraspinatus tendon suffers the majority of injuries, however the rotator cuff may also be affected. Fraying is frequently the first sign of damaged tendons. The tendon may totally tear and worsens when carrying a big object. As a result, doing numerous daily chores combing your hair or getting dressed may become uncomfortable and challenging.

Tight scapular or Frozen Shoulder

Many of my clients have tight scapulars that don't move very well, and they complain of shoulder pain and or neck pain and often the culprit is the subscapularis the muscle underneath the scapula, and also the serratus posterior, they flatten or wing our scapulars.

So an effective way to reduce this pain is to use  a myofascial release technique.

Let me show you the things I do

  • Get a stretch of the muscle and the overlying fascia.
  • Bring their arms straight up to about 90 degrees and then bring the arms in whilst we pin the scapulars.
  • Use a towel because your fingers under their armpits is not a very comfortable position.
  • Find that lateral border of the scapula, pin down and backwards.
  • Bring your arms up forward.
  • Encourage your patient to get them to about 90 degrees, and then elbows straight,and what they should feel is a slight stretch.
  • Bring the hands in together, elbows in together.
  • So your client is actively doing the Myofascial work. It's not an indirect technique. It's a direct technique.

Carpal tunnel with Myofascial Release

Carpal tunnel is a condition that can affect anyone, but is more common in people over 50. The sensation in the hand and finger joints is like having a tight band around the hand. This annoying, aggravating pain that travels down into the hand and wrist is at some point both neural as well as muscular.

Let me show you the things I do

  • Ask your patient to squeeze your fingers as hard as she/he can. This grip strength test gives us a before and after benchmark.
  • Try to work on your patient  pecs and down the arm rather than only focusing on the wrist.
  • Put a little bit of lubricant on your fingers, not a lot because we need to get some good purchase with the skin, we then glide or MFR through that bicep, make sure that the client feels relaxed in the forearm and wrist through this manoeuvre.
  • Continue with the myofascial work on the forearm flexors before you start to go local. You’ll see some good changes if we work on the entire train of connective tissue in the arm.

Shoulder Impingement with a touch of focus to the thorax

Shoulder Impingement is the result of tissue irritation or damage. It can occur due to overuse, muscle spasms, arthritis, general wellness issues, or even from lifting an extra heavy object. What causes impingement is unclear, but it is often accompanied by sharp, shooting pain in the shoulder blade area.

A patient of mine presented with a nasty shoulder impingement on his left shoulder so reaching up, certain press exercises, anything overhead was really sore and couldn’t lift anything heavier than a really light weight; we set out treating with usual neuromuscular techniques and then tweaked it with my personalised neurolymphatic work hoping to get a result. Within this one session the results were excellent.

  • Try to get some kind of really good biomechanical movement through the shoulder.
  • The tricky subscapularis is quite often a problem, at first I just did a pin

 and stretch and got him to go  through his shoulder range.

  • Because he didn’t have good range I tweaked it with a little bit of the thoracic work using Chapman's Reflexes or the neurolymphatic points.

By following the tips above, you can take control over your shoulder and wrist pain. You deserve to be in charge of your own health and wellbeing. By employing some of these methods into your daily routine, you can save time and get relief faster. The best way to get rid of shoulder and wrist pain is to avoid doing something that causes it in the first place. That being said, some movement is necessary for health and fitness. Exercising your affected shoulder or wrist does not have to be painful. If you're experiencing pain in your shoulders and wrists, then keep in mind that it's important to find a manual therapist like a remedial massage therapist who can help relieve your pain and discomfort effectively. With the right treatment, you will most likely be able to return to your activities and work without having to worry about future problems with your shoulders or wrists.

The good news is that most of my clients find relief with the help of my treatments. Now, it’s your turn. Go implement what you’ve learned here in this article and let me know how it goes.

Watch to learn more on how to effectively relieve shoulder and wrist pain.

Here’s a short video I have made to show you how exactly you can do this from your clinic and your patient to their homes.

Follow my YouTube Channel @ www.youtube.com/@PaulaNutting
October 28, 2022 Paula Nutting

Want To Know A Quick And Lasting Relief For Shoulder Pain And Shoulder Impingement? Learn These Three Simple Tricks

Shoulder pain and shoulder impingement are common problems for many people. They can be a result of an injury or overuse of the shoulder muscles. The pain is usually caused by inflammation in the tissues and joints.

This article will provide some information on how to reduce the pain and symptoms of shoulder impingement.

It includes three simple tricks that can be done at home to help relieve some of the pressure on your shoulders.

Common Causes of Shoulder Pain and Shoulder Impingement

The shoulder is a complex joint and has the greatest range of motion of any joint in the body. 

It is also one of the most mobile joints, which means it is susceptible to more injuries than other joints. 

The shoulder injury comes in many ways, such as by a fall on an outstretched arm, or by repetitive overhead movements.

The causes of shoulder pain and shoulder impingement are varied and depend on the type and severity of the injury.

They include your age, occupation, physical activity level, and genetics. 

Some common causes are:

  • Overuse injury from repetitive overhead motions
  • Muscle strain or sprain from falls onto outstretched arms
  • Bursitis from overuse
  • Rotator cuff tear from falls or contact sports
  • Tendinopathies (Bruised Tendon)
  • Adhesive capsulitis (Frozen shoulder)

Three Simple Tricks for a Quick and Lasting Relief on Shoulder Pains and Shoulder Impingement

Trick #1: Myofascial work with our Sternocleido Joint (SC Joints)

Now your Sternoclavicular Joint (SC Joint) is part of the clavicle. It's also going to be affecting the scapula and how the shoulder sits in that socket space. 

When we have fixations or stickiness in that SC joint, it can actually make a difference to the first rib. 

This can cause a whole band of problems with the neck as well.

We're applying some myofascial glides with our Sternoclavicular Joint.

  • Drop down into the manubrium, the manubrial space and over onto the SC joint, thumb over thumb
  • Compress down onto the SC joint and pushing it carefully
  • Get your client to bend their elbows
  • Have the client do some active movement
  • Depress the SC Joints
  • Draw down and back on that little saddle joint
  • Encourage the SC joint to do its saddle action

At start this can be sticky and tender, but this is also a nice joint mobilisation technique.

Use it on anyone who's exhibiting first rib stiffness, shoulder pathologies or even just when the SC and AC joints feel a little bit stiff and sticky.

Trick #2: Distraction and relaxation with Thera bands

When patients come to see us with aggressive chronic shoulder pathologies, it may be caused by inflamed tendons.

It can come from bursitis, tears and strains.

It can be part of adhesive capsulitis too.

We can do myofascial release techniques, glides and mobilisation techniques.

The gold nugget is what you can ask your patients to do for home care. 

That’s what makes the difference.

Warning - this is contraindicated for patients with unstable or hypermobile joints.

Now, ask your patient to place that Theraband onto his/her shoulder as shown in the image above.

The other underneath the foot on the side of the complaint. 
Let the Thera band sit at the humerus, not on the shoulder joint.

Do the pulling down then up as shown in the video.

Trick #3: Muscle Energy Technique to improve the Shoulders’ Internal & External Rotations

The Muscle Energy Technique is a physical therapy technique used to improve the mobility and function of muscles that are not working properly. 

It is also used to help with pain management and reduce spasms in muscles. 

This technique can be done by a therapist or by the patient themselves.

Let your patient lie down and do the following:

  • Gently abduct the shoulder up to just slight of 90 degrees
  • Let the arm passively externally rotate
  • Then look at the patient’s internal range
  • With 40% effort, ask the patient to push up into his/her arm,while you are holding it still. No movement for 7 to 10 seconds
  • Patient then takes breath in and breathe out
  • As the arm relaxes, don't change our joint angles (post contraction relaxation phase)
  • Do this for about 3x times

These techniques are awesome if you want to improve shoulder mobility and function. 

They are brilliant in helping with pain management and reduce spasms in muscles.

Watch the full video demo of all three techniques here:

https://youtu.be/vFcYRhdj1do

When people think of a solution for shoulder pain, they usually think of going to a doctor and getting prescribed medication. But what if there was an easier way?

The three tricks that we have mentioned in this article can be done anywhere and anytime.

It makes them a perfect solution to shoulder pain relief fast and lasting.

Blog Image about Relief from Sub Occipital Pain – Effective Solutions with Manual Technique (1)
Manual Technique neck neck pains stretching exercises Sub Occipital Pain
October 7, 2022 Paula Nutting

Effective Solutions of Sub Occipital Pain with Manual Techniques

Suboccipital pain is a common type of chronic neck pain. It affects millions of people around the world, which makes it one of the most common types of neck pain. 

Even though the primary cause of this type of pain is unknown, there are effective treatment options that can help relieve the symptoms. 

If you’re reading this article, it’s probably because you already know something needs to change in your life and that you’ve tried everything else. 

There are so many reasons why we need to take action against suboccipital pain – not only for our health but for our well-being as individuals too. 

What is Suboccipital Pain? 

x-ray visual of sub occipital pain of a man

It is a condition that is commonly caused by tightness in the muscles and connective tissues around the base of the skull. 

It can also be caused by compression of the nerves in this area. This condition can be very debilitating and cause a great deal of pain.

Causes of Suboccipital Pain

The suboccipital muscles attached to your occiput can be tender and sore if you sit at a desk or in front of a computer for long periods of time. It is common for people who sit for long periods of time to develop tension headaches. These muscles help to keep the head in place and prevent cervical vertebrae misalignments.

  • Prolonged tilting of head especially while working at the desk or when reading
  • Prolonged tilting of the head backwards or on the side especially when you are tucking a phone between ear and shoulder , when watching a screen located to your side, when the person you are talking to sits next to you, when doing painting jobs or when climbing
  • Cold draught which happens when your muscles are tired and got shortened for a longer time and you got exposed to cold draught (I suggest you put a scarf around your neck to avoid this)

Manual Techniques Never Seen for Reduced Neck Range of Motion that may Create Pain

1. Sub Occipital Pain Midfoot  Massive Supination

Asian woman doing to put a lock on the hindfoot sub occipital pain

You'll probably see this with a lot of clients that you'll have one foot that's got massive supination and the other one that's not as supinated. 

Now there are a couple of ways we can address that we can have a look to see if it's the midfoot, the cuboid muscle that is cuboid bone, that has been locked up. 

That's because of the torque or the pull between the tibialis anterior and the perennials that share in a common attachment point of the midfoot. 

Their action is to draw up that foot arch, we can have some jointly restrictions going on with the navicular head and the talus bones. It can be either of these structures that creates a problem, let’s assess in this video.

Let me demonstrate how I've achieved amazing results from it.

  • Put a lock on the hindfoot, and then put your hands on the forefoot that is free floating.
  • Move it back and forth to see if we are able to unlock the intercuneiform joints. Occasionally you feel a click from the action or, sometimes, you'll hear the click. This is NOT high velocity thrusts but simply the joint moving over surrounding bones or a nitrogen bubble release.
  • Then move to the second point. Feel if the navicular or talus bones are sitting just a bit more anterior-lateral than normal. 
  • Both thumbs on the bone/s, rock the ankle into some dorsiflexion for about 30 seconds, while they notice any pain and/or stiffness. It can be quite uncomfortable.

2. Sub Occipital Pain Recurring tightness in Upper Cervical Muscles or (suboccipital muscles)

x-ray visual of sub occipital pain of a woman

Are you a practitioner with clients or patients who come to see you who have constant tightness in their lower cervical muscles, specifically the ones that run along the deeper gutter of the neck, and attached to the base of the skull? 

They're referred to as our suboccipital muscles. These are the muscles that our patients often say are very tight. Comments like “It doesn't matter how much I try it doesn't seem to help the tightness”. 

In the long run, we are able to do lots of work with neuromuscular techniques. 

We can use exercises to increase muscle energy as well as glides, and we can also do joint capsule mobilization, however this is more universal and something I've seen in my clinic that's gained a bit longer duration for both the patient and the client. 

Following the patient's evaluation of the cervical movement.

Let me demonstrate how I've seen amazing results from it.

  • Ask the patient to go through upper cervical ranges. They will chin poke and chin tuck; trickier to do so I ask them to make a double chin. 
  • They will lie in supine, you'll need to feel your hands descending to the table, and your neck feels as if it's lying flat in front of the pillow. 
  • Have them bend their knees and put their feet flat, creating the bridging motion by elevating the buttocks off the table. They are asked to activate the gluteus maximus, which are those massive bionics power drivers to lift the pelvis and hips off the table. 
  • We can experience some beautiful stretches all the way to that thecal area, and coming down the full line of the spine
  • When we get them into a sustained bridge we then increase the pull at the top of this line by adding a pull or drag on the occipital ridge. We are pulling the neck into flexed traction and it works brilliantly for giving extra stretch and length in resting to the back fascial lines of the body.
  • Apply 3 times before you reassess.

3.  Sub Occipital Pain Severe Lateral Cervical Tenderness

Severe Lateral Cervical Tenderness of a man sub occipital pain

I've been seeing clients coming with really restricted neck ranges and quite extreme cervical tenderness on the lateral side. 

It is possible to perform a lot of work on the neck. However, what we really need to do is to discover how we can assist those clients with homework maintenance. 

We also need to assess so we can get a more detailed look at the things taking place that require change. 

This treatment always occurs after conducting an assessment on the client.

Let me demonstrate how I've seen amazing results from it.

  • Check the ranges of movement through flexion, extension, rotation and lateral flexion. Note before and after ranges.
  • We are addressing the deep and superficial arm lines of the anatomy trains. We look at the links between the entire pathway from neck, shoulder, arm, wrist and hand. This is important because a break in the continuity of any of these will make myofascial pain changes to the patient.
  • If there is restriction in the neck, I will move my attention to the hand and to the finger webbing. This may sound odd but I want you to check your necks and webbing and see if you can’t notice a correlation between tenderness and reduced neck movements.
  • Apply a lubricant rather than oil to your fingers. Oil is too slippery and will not give enough grip as you glide proximal to distal between the MCP joints.
  • Make sure that the patient relaxes their arm. Apply your thumb and fingers in the skin just below the MCP joints and then draw them through the webbing between the fingers and off.
  • Go through the web at least three or four times. After that, the same procedure through all the webs to pick up any tightness, tension or bound feelings between each finger knuckle to skin.
  • Do the same process to the other arm. 
  • Once complete, we will retest ROM and if there is a significant result then this will be part of the home care routine.

4. Trigger point therapy

This therapy involves applying pressure on specific muscles or bands within the muscle that create myofascial pain syndromes. 

These muscles seem to react well to triggering whether it be by compression, squeeze/flushing, acupressure or dry needling. 

Can must be used to confirm that it is the muscle you are addressing and not other neural tissue. 

Some patients love it though it can be quite painful during the application.

5. Massage

Massage is one of the most vague definitions in the dictionary for ways to relieve muscle tension. It includes glides, effleurage, kneading and should include techniques including NMT, MET, MFR. 

The old comments like “improve blood circulation” are no longer valid, nor is drinking water post a massage to remove toxins.

Probably the greatest value from receiving a massage is the activation of the parasympathetic nervous system. The body calms to serotonin, dopamine, oxytocin and more feel good chemicals aroused in the body. 

There is true value in this kind of relief, especially with clients under a lot of stress.

6.Stretch 

Stretching is another great way to relieve muscle tension and improve resting tone and active range of motion. There are many different stretching exercises that you can do at home or at work. 

Talk with your remedial therapist or exercise practitioner who will find ones that work best for you and do it regularly throughout the day. 

Remember to breathe deeply while stretching as this will also help relax your muscles.

These manual techniques can be helpful in treating this suboccipital pain and many other types of pain experienced in the body. 

If you’re not sure which techniques are right for you, consult with a qualified massage therapist who can help you choose the best option based on your individual needs.

I have found that these techniques are often very effective in relieving suboccipital pain. 

By applying techniques more distal to the neck can help to release tension in the muscles and tissues around the neck and head. 

This can often provide significant relief from pain and help to improve the range of motion. 

For a better understanding of these techniques please click on the link to the video below.

👇👇

Watch This Video and Subscribe to Learn More!

You tube - https://www.youtube.com/watch?v=Rt-eDY7PLKc

References

National Library of Medicine, BMC Musculoskelet Disord. 2017 Published online 2017 Sep 5.Effectiveness of a specific manual approach to the suboccipital region in patients with chronic mechanical neck pain and rotation deficit in the upper cervical spine: study protocol for a randomized controlled trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584013/

National Library of Medicine, Author Tom George; Prasanna Tadi, Update January 10, 2022. Anatomy, Head and Neck, Suboccipital Muscles https://www.ncbi.nlm.nih.gov/books/NBK567762/

Myofascial Energetic Length Technique Blog Banner
foam roller Myofascial Energetic Length Technique Myofascial Release
August 10, 2022 Paula Nutting

Myofascial Energetic Length Technique: Why You Should Try It?

Overview

Ms. Sue Hitzmann developed a self-treatment system to manipulate and rehydrate the connective tissue. (MELT stands for Myofascial Energetic Length Technique.) Once you learn the method, she said, just 10 minutes three times a week is all you need (Lawlor, 2021 )

“The MELT Method focuses on rehydrating your connective tissue and rebalancing the nervous system to eliminate stuck stress and improve whole body efficiency.”  

Sue Hitzman

MELT Method creator Sue Hitzmann defines it as a hands-off approach to dealing with pain and injury that increases your strength, balance, and flexibility by restoring the stability of your connective tissue.

WATCH: Paula Nutting with Sue Hitzmann, Myofascial Energetic Length Technique

3 Methods of the Myofascial Energetic Length Technique

Rebalance with a Soft Body Roller/Foam Rolling

Nervous System Myofascial Energetic Length Technique

According to Chertoff (2019) Foam rolling is a self-myofascial release (SMR) technique. It can help relieve muscle tightness, soreness, and inflammation, and increase your joint range of motion. Foam rolling can be an effective tool to add to your warm-up or cooldown, before and after exercise. 

Here are some benefits of using foam rolling (Chertoff, 2019);

  • Ease muscle pain
  • Increase range of motion
  • Temporarily reduce appearance of cellulite
  • Relieve back pain

Rehydrate with a Foot Treatment

Foot Myofascial Energetic Length Technique

For this foot treatment, try to keep your head up and not look at your feet.

Instead, use your body sense to feel if you have the ball in the right spot.

You can stand next to a wall or chair to help you balance, if necessary.

Keep the pressure tolerable, and if you feel pain, back off (Miller, 2017)

Rehydrate with a Hand Treatment

Hand Myofascial Energetic Length Technique

Sue recommends doing the self-treatment techniques three times a week — even better, every day — to get immediate relief by rehydrating this tissue and reacquiring space in your joints (YOM Staff, 2020) 

  1. Position-point pressing
  2. Gliding
  3. Shearing
  4. And friction on your hands and arms.

“The MELT hand and foot treatment are designed to rehydrate connective tissue which is a real missing link to pain and learning how to address connective tissue in a very efficient way is what this methodology all about. In rehydrating connective tissue you could actually rebalance your nervous system and get your body’s natural healing mechanisms back on track. . . . . so in just minutes you can self treat your hands and feet and improve whole body communication and balance”

Sue Hitzman

Rebalance with the Neck Release

Neck Foam Roller Myofascial Energetic Length Technique

According to Lindber (2021) The neck release is a gentle way to loosen tension in both your shoulders and neck.

Here’s how to do it for MELT Method;

  • Slowly turn your head from right to left
  • Next, go to a sideway position
  • Use foam roller and place it underneath your head
  • Then, start to create small circles using your head while in sideways position
  • Repeat on the other side.

Here are some possible benefits of Rebalance with the neck release MELT Method:

1. Improved posture and alignment

2. Decreased neck pain

3. Increased range of motion in the neck and shoulders

4. Reduced tension headaches and migraines 

5. Better sleep quality (reduced stress on your muscles)

The idea is that you don’t have to hurt yourself to get rid of the pain. The MELT method is a self-treatment technique that encourages your body’s innate ability to stay healthy by rehydrating the connective tissue system.

Did You Know?

Connective Tissue Fascia

Fascia connects all of our muscles and tendons into one cohesive system and plays a part in everything from our posture to balance to digestion.

When it becomes dehydrated by daily stress, poor diet, and lack of exercise, it works less efficiently, resulting in aches, pains, tension headaches, poor posture, and stiff joints and muscles.

Myofascial Energetic Length Technique is used to reduce inflammation in the fascia system by activating the myofascial meridians. The fascia system is made up of connective tissues throughout your body that help your organs function properly.

When these tissues become inflamed or injured due to repetitive movement patterns or prolonged bouts of stress, they can become painful and restrictive to movement.

Conclusion

Myofascial Energetic Length Technique has been shown to increase circulation and relieve pain in the muscles and joints by increasing the length of their meridians through self-massage therapy using pressure points along their length. This increases blood flow through these pathways which helps improve range of motion and reduces pain because there are fewer restrictions on how far you can move each joint (and therefore how much force it can bear).

The MELT technique can be done anywhere at any time as long as you have access to a chair or wall for support. You'll need some room in front of you so that you have enough space between your hands and feet during each movement.

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References

Lawlor (2015). Rolling and Flexing to Massage Away Pain and Stress. https://www.nytimes.com/2015/01/02/arts/a-class-in-the-melt-method-of-body-work.html#:~:text=the%20same%20effect.-,Ms.,week%20is%20all%20you%20need

Chaudhry et.al (2017). Effect of MELT method on thoracolumbar connective tissue: The full study. https://pubmed.ncbi.nlm.nih.gov/28167175/

Ruback (2020). Validation of a Mindful Practice: The MELT Method. https://search.proquest.com/openview/f1f710c2f2ff7f9edd3eb7be92187ac4/1?pq-origsite=gscholar&cbl=18750&diss=y

Chertoff (2019). What Are The Benefits Of Foam Rolling? https://www.healthline.com/health/foam-roller-benefits#back-pain

Miller (2017). Do This Foot Treatment Tonight Before You Go To Sleep. https://www.womensrunning.com/health/do-foot-treatment-before-sleep/

YOM Staff (2020). Improve Your Hand Strength with MELT. https://www.yomreporting.com/blog/blog/post/improve-your-hand-strength-with-melt

Mansour (2019).How to use a foam roller to relieve neck, back and knee pain. https://www.nbcnews.com/select/lifestyle/how-use-foam-roller-relieve-neck-back-knee-pain-ncna978301

Painful wrist remedies and treatment banner
chapmans reflexes Panful Wrist Wrist pain Wrist remedies
August 4, 2022 Paula Nutting

Know How to Treat Painful Wrist: Simple Remedies

Overview

If you’re suffering from a painful wrist, don’t worry! It’s completely treatable. Undoubtedly, for those with painful wrist due to some fell down, accidents while doing household chores, or while performing your skateboard stunts.

There are treatments and remedies for that pain, mobility with rotations, medial, and lateral rotation may be just what you need to treat your condition.

Besides, these treatments will help you get back to your daily activities without pain interfering with your quality of life. In fact, our recommended treatment is one of the most effective non-surgical solutions available today.

What is Wrist Pain?

A wrist joint is a joint that connects the hand to the forearm. A wrist fracture takes place when a person broke one of the small (carpal) bones in this joint or commonly, the distal radius, which is twice the size of the two bones that make up the forearm. In addition, this bone often breaks on the lower end part, which is near to where it connects the bones of the hand and thumb.

An image of a hand with fingers over it showing pains on a person's wrist

Injuries

Sudden impacts. Wrist injuries often occur when you fall forward onto your outstretched hand. This can cause sprains, strains and even fractures. Thus, a scaphoid fracture involves a bone on the thumb side of the wrist, and this type of fracture may not show up on X-rays immediately after the injury.

Repetitive stress. Any activity do involves repetitive wrist motion — from hitting a tennis ball or bowing a cello to driving cross-country — these can inflame the tissues around joints or cause stress fractures, especially when you perform the movement for hours on end without a break. De Quervain's disease is a repetitive stress injury that causes pain at the base of the thumb.

Prevention

It's impossible to prevent the unforeseen events that often cause wrist injuries. Even so, these basic tips may offer some protection:

Build bone strength. Getting adequate amounts of calcium — 1,000 milligrams a day for most adults and at least 1,200 milligrams a day for women over age 50, — can help prevent fractures.

Prevent falls. Falling forward onto an outstretched hand is the main cause of most wrist injuries. To help prevent falls, wear sensible shoes. Remove home hazards. Light up your living space. And install grab bars in your bathroom and handrails on your stairways, if necessary.

Use protective gear for athletic activities. Wear wrist guards for high-risk activities, such as football, snowboarding and rollerblading.

Pay attention to ergonomics. If you spend long periods at a keyboard, take regular breaks. When you type, keep your wrist in a relaxed, neutral position. An ergonomic keyboard and foam or gel wrist support may help.

Steps for Treatment and Remedies:

Sometimes we may encounter events where we do disruption to the joints, which results in fractures. Or could be an interosseous membrane, (a thick dense fibrous sheet of connective tissue that spans the space between two bones forming a type of syndesmosis joint), which is the membrane between the owner and the radius that contracts and be caught in that kind of position.

Addressing mobility with rotations, medial, and lateral rotation

  • Loosen through the interosseous membrane by pouring the right amount of oil on the hands; make them move through the soft tissue well.
A remedial massage therapist gliding down a finger over the wrist of the patient
  • Glide down with your thumb between the radius and the owner.
A remedial massage therapist pressing down a finger on the arm of the patient
  • Roll a thumb over that taut band.
  • Move all the way to the wrist joint.
A remedial massage therapist rolling a thumb on the arm of the patient
  • Next maneuver is to take fingers to the back of the wrist.
A remedial massage therapist maneuvering fingers on the wrist of the patient
  • Gently glide it on a round motion with a thumb
A remedial massage therapist gliding down a thumb on the arm of the patient in a round motion

The gentle rolling motions in this exercise will help loosen the wrist joint. Roll up and down the length of the arm, finishing above and below the wrist joint.

If you have pain in your wrist, this exercise will be good for you. It’s easy to do and can be done anywhere: at the office, while watching TV or eating dinner with friends. You can even do it with your eyes closed if that’s what floats your boat!

Do this a few times each day to ease pain quickly and strengthen your wrist for future strong use.

The exercises that you do for your wrist can be done a few times a day to ease pain quickly. You should do them every day so that they become part of your routine and strengthen your wrist for future strong use. The exercises will help you to feel better, get stronger, and get better!

Lie on your back on a flat padded surface with your arms at your sides, palms facing down.

Lie on your back on a flat padded surface with your arms at your sides, palms facing down.

Place your head on a pillow and relax.

Slowly lift the affected arm straight up over your head until you feel a stretch through the affected side of your body.

  • Slowly lift the affected arm straight up over your head until you feel a stretch through the affected side of your body.
  • Don't force it, and don't hold your breath. Don’t arch your back or bounce when lifting it; just move gently in a natural way.
  • After holding the stretch for several seconds, release and allow the muscle to relax again before repeating this process on the other side (if applicable).

Hold for 10 seconds, then slowly lower arm back to the floor and repeat 10 times.

Hold for 10 seconds, then slowly lower arm back to the floor and repeat 10 times.

You should do this a few times each day. It will relieve pain quickly and strengthen your wrist for future strong use.

Give these exercises a try today to see what you need to do.

  • Use the following exercises to get rid of pain in your wrist:
  • Grab a bottle of water and hold it on your hand with both hands, palms facing up.
  • Then stand up straight, raise one leg so that it is just above hip height and then bend at the waist as far forward as possible until you feel a stretch in your lower back (make sure not to move too far). Hold this position for 30 seconds before switching over to the other side.
  • Sit down on a chair with both feet flat on ground and place hands behind head supporting weight of neck/head through shoulders/chin area; keep chest out lifted up slightly off seat cushion but don't let chest sink too low- make sure not push against table edge!

All content provided on this site is for informational purposes only and should not be used to diagnose or treat a health problem or disease without the advice of a healthcare professional.

Watch this Video

Here's a video brought to you by Paula Nutting, Your Musculoskeletal Specialist, where you can see how to do this treatment and remedies effectively. Watch to go through these steps so you can practice from your clinic and also what homecare you can offer your patients when they are not in your practice. Click here

https://youtu.be/7awXHWjYxbY

"Having a great time reading this article, share it with with your friend or other people who you think will benefit with this post..."

References

Yale Medicine (2022). Wrist Fracture: Causes, Diagnosis & Treatment. Retrieved June 07, 2022, from https://www.yalemedicine.org/conditions/wrist-fracture

Mayo Clinic (2022). Wrist Pain. Retrieved June 06, 2022, from https://www.mayoclinic.org/diseases-conditions/wrist-pain/symptoms-causes/syc-20366213#:~:text=Overview,arthritis%20and%20carpal%20tunnel%20syndrome.

elbow pain tips and hacks for effective treatment
Arthritis Pain chapmans reflexes Elbow Pain Painful Elbow
July 21, 2022 Paula Nutting

Free from Elbow Pain: Useful Tips & Remedies

Overview

If you’re suffering from elbow pain, which is caused by Arthritis. There are treatments and remedies for that, with maneuvers and skin pulling for mobilizing the nerves,  which may be just what you need to treat your condition.

Besides, these Tips and Hacks will help you get back to your daily activities without pain interfering with your quality of life. In fact, our recommended treatment is one of the most effective non-surgical solutions available today.

Elbow Pain Causes

According to Penn Medicine (2022) Elbow arthritis takes place whenever the cartilage in the elbow is embellished , worn or damaged.

Here are some of the most common causes:

  • Overuse due to age
  • Stress and tension
  • Fracture or dislocation.
  • Trauma (such as a fall) or incorrect use of your arm/hand/fingers
  • Degenerative conditions such as osteoarthritis, rheumatoid arthritis or carpal tunnel syndrome

In  addition, Elbow arthritis can be extremely painful and can interfere with daily tasks that involve bending your arm.

Know more about Elbow Pain

If you have elbow pain, and  maybe one of the various disorders listed below  could be the reason behind that pain. Meanwhile, worn out, sports, or household related injuries cause many elbow conditions. Golfers, baseball pitchers, tennis players, and boxers often have elbow disorders, (Briggs, 2020)

Elbow pain may involve any of the following

  • Arm Muscles
Arm showing musculoskeletal anatomy
  • Elbow Ligaments
image showing elbow ligaments
  • Tendons
image showing a hand with a ben pointing at a model of tendons
  • Bones in the Arms
woman wearing white shirt with elbow pain
  • Bursae

Elbow Pain Treatment

Elbow pain is a common injury that can affect people at any stage of their lives. It's also one of the most painful types of injuries, which means that doctors and physical therapists often recommend treatment options for elbow pain. While there are many ways to treat and prevent elbow pain, some methods work better than others. Elbow pain treatments vary depending on the scale of pain and symptoms you are  experiencing. Nevertheless, most elbow pain requires conservative treatment. Surgery is a last resort if your symptoms don’t improve.

Your treatment options include:

Ice

  • Ice the elbow for 15 minutes. A bag of frozen vegetables works well, or you can use a cold compress on your elbow.
  • Rest the elbow in an elevated position for 20 minutes to 30 minutes each day, such as by putting one leg up on a stool and resting the other on the floor below it or even leaning against something (such as a wall). This will help reduce swelling and inflammation around your joint while allowing blood flow through it easier so that it doesn't get clogged up with dead cells and other unwanted material like bone spurs or calcification which can cause further damage over time.

Rest

Rest the elbow in an elevated position for 20 minutes to 30 minutes each day, such as by putting one leg up on a stool and resting the other on the floor below it or even leaning against something (such as a wall). This will help reduce swelling and inflammation around your joint while allowing blood flow through it easier so that it doesn't get clogged up with dead cells and other unwanted material like bone spurs or calcification which can cause further damage over time.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

If you’re experiencing elbow pain, there are many different options for treatment. One of the most common methods used in treating elbow problems is medication. Medications can be helpful in reducing pain and inflammation, but they may not help with the underlying cause of your injury. Nonsteroidal inflammatory drugs such as ibuprofen may be prescribed by doctors in severe cases but these medications come with side effects such as nausea, should only be taken if prescribed by medical professionals.

Physical therapy

Physical therapy is another option many people choose when they're experiencing chronic pain due to injuries sustained while playing sports such as basketball or football where there could have been injury sustained during playtime.

Other Ways to Prevent Elbow Pain

Most elbow pain is the result of overuse and injury.

You can prevent them by:

  • correcting improper sport techniques
  • using a proper-sized grip on sports equipment
  • using correct tension on racquets
  • warming up and stretching properly
  • using elbow padding

It’s also important to take breaks from repetitive tasks. Practice exercises that can help strengthen the muscles around your elbow joint.

Exercises for Elbow Pain Relief

  • Stretching
  • Strengthening exercises for the biceps, triceps and forearms:
  • Biceps curls: With a dumbbell in each hand, hold it at shoulder height with palms facing forward. Lower until your arms are at 90 degrees and then raise up again. Repeat 10 times in total before resting for one minute. Then repeat on other arm. Do this two times per day if you have elbow pain in both elbows or just once if it's only one elbow that hurts (or maybe even three times).
  • Tricep kickbacks: Stand on an exercise ball (or similar) with feet hip-width apart so that you are balanced on the balls of your feet; bend knees slightly while keeping hips square; lift hips slightly as if sitting back into a chair (but don't let them go down); slowly lower back down until thighs come off floor; repeat 15 times then rest 30 seconds before repeating again!

Professional Help with Elbow Pain

If you're suffering from elbow pain and can't seem to find a solution, seeing a doctor is the best way to get treatment. The first step is getting an x-ray or CT scan of your elbow. This will help determine what's wrong with your joint and whether there are any other problems involved in its development. You may also need blood tests done as well as an exam by a physical therapist who can evaluate how well your muscles function at rest (which could indicate muscle weakness) or during movement (which could indicate muscle tightness).

When it comes time for diagnosis and treatment, talk with your doctor about the potential causes of elbow problems. Some people might benefit from nonsurgical options like pain relievers such as ibuprofen while others may require surgery if they have advanced arthritis in their joint cartilage—though this decision should be made after careful consideration based on recent findings about how much arthritis affects different parts of our body differently depending on where they sit within them overall structure."

If you have arm pain that persists, see a doctor.

If you have arm pain that persists, see a doctor. If the pain is severe or lasts more than a few days, see your doctor right away.

  • Pain accompanied by swelling: If you feel the pain in only one part of your elbow and it's accompanied by swelling around that area (inflammation), then this could be an indication that there is something wrong with either tendons or ligaments in your arm bones. In this case, it could be helpful to speak with an expert who can help determine whether or not surgery is needed; however, sometimes just rest will do the trick on its own!
  • Pain accompanied by weakness/numbness: Weakness or numbness from arthritis can cause problems throughout the body—especially when combined with fatigue due to poor circulation—so it’s important for anyone experiencing such symptoms not just focus on themselves alone but also seek medical attention right away if possible so they don't wind up doing anything harmful like cutting off circulation even more than normal because we all know how bad having severed limbs would feel!

All content provided on this site is for informational purposes only and should not be used to diagnose or treat a health problem or disease without the advice of a healthcare professional.

Watch this Video

Here's the most effective video where you can see how to do this treatment and remedies effectively. Watch to go through these steps so you can practice from your clinic and also what homecare you can offer your patients when they are not in your practice. Click here

https://youtu.be/uY5wxoWA6JA

"Having a great time reading this article, share it with with your friend or other people who you think will benefit with this post..."

For More Readable Articles: Click Here

References

Penn Medicine (2022). How to Treat Elbow Arthritis. Retrieved June 14, 2022, from https://www.pennmedicine.org/for-patients-and-visitors/find-a-program-or-service/orthopaedics/elbow-pain/elbow-arthritis#:~:text=Elbow%20arthritis%20occurs%20when%20the,that%20 involve%20 bending%20your%20arm.
Spriggs, B. (2020). Elbow Pain Types of Disorder. Retrieved June 15, 2022, from https://www.healthline.com/health/elbow-pain#types-of-disorders

Muscle Energy-Technique-for-Shoulder Rotator Cuff Pain Chapmans Reflexes
Muscle Energy Technique rotator cuff shoulder injury shoulder pain
April 9, 2022 Paula Nutting

Muscle Energy Technique (MET) for Shoulder Rotator Cuff Pain

Overview 

Learn Muscle Energy Technique Shoulder Rotator Cuff Pain today. If you’re suffering from rotator cuff pain, don’t worry! It’s completely treatable. For those with shoulder pain due to rotator cuff tendonitis, inflammation, or impingement, applying a Muscle Energy Technique (MET) may be just what you need to treat your condition and get back to your daily activities without pain interfering with your quality of life. In fact, our recommended treatment is one of the most effective non-surgical solutions available today.

Muscle Energy Technique for Shoulder Rotator Cuff Pain- Chapmans Reflexes Blog Image

Related Article: Neck and Shoulder Office Exercise

Why do we need rotator cuff muscles?

According to Athwal (2017), the rotator cuff is a set of four muscles that form a "cuff" over the head of the humerus via tendons. The scapula leads to the four muscles that make up the following muscles:

Rotator Cuff Muscles and four parts- Chapmans Reflexes Blog Image

Photo courtesy of A.D.A.M., INC.

The larger and lesser tuberosities are where the rotator cuff tendons join to the humeral head. These muscles altogether allow the rotator cuff to perform its important role of arm lifting and rotation as well as the stabilization of the shoulder's ball within the joint (Maruvada et al., 2021)

What is a Muscle Energy Technique (MET)?

Muscle Energy Technique (MET) is a type of soft tissue manipulation used to treat muscle imbalances and other issues. This was developed by Fred Mitchell, Sr. and Fred Mitchell, Jr. In MET, small contractions are used to stretch a tight muscle while they’re in their shortened state. The purpose of MET is to gain control over trigger points and improve mobility in muscles with limited range of motion. MET is an active approach in which the patient acts as in active participation, as opposed to static stretching, which is a passive technique in which the therapist does all of the work.

MET can be beneficial for improving stability in both shoulders. Athletes who perform overhead movements, like baseball pitchers or swimmers, tend to experience shoulder pain due to injuries like rotator cuff tears or labral problems. While steroids injections can help reduce shoulder pain and inflammation caused by these conditions. They only treat symptoms—not underlying causes of shoulder pain. In addition, it may have negative side effects if not administered correctly by professionals.

Related Article: Muscle Energy Technique Your Therapist Does For You

When should you use muscle energy technique (MET)?

Muscle Energy Techniques can be utilized for any issue where the goal is to relax and lengthen muscles while also improving joint range of motion (ROM). Almost any joint in the body can be safely treated with METs. A lot of athletes employ MET as a prophylactic treatment to avoid muscle and joint injury in the future. It is mostly utilized by those who have limited range of motion in their neck and back owing to facet joint dysfunction. Likewise, for larger issues including shoulder discomfort, scoliosis, sciatica, asymmetrical legs, hips, arms. It could also treat persistent muscular pain, stiffness, or injury.

Muscle Energy Technique (MET) for Shoulder Rotator Cuff Pain

How do you perform Muscle Energy Technique (MET)?

Muscle energy technique is effective for shoulder pain relief and it's easy to learn which is why its use in recent years have increased. Here's how you can do it for your patients. 

Physical Examination (Muscle Energy Technique Shoulder)

You will have to look at the natural range or passive range of movement of the patient. Have your client lie supine and you move their arm into abduction to a 90° angle.

External rotation of the shoulder, natural range or passive range of motion ROM should be between 80 and 90° degrees-Chapsman Reflexes Blog Image

Bend the elbow and passively check for external rotation of the shoulder as seen in the photo below. You are assessing their current ROM or the limits to their range of motion, normal range should be between 80 and 90°. If the range of external rotation is less than these numbers it can indicate that either the pectoralis major, the latissimus dorsi, and/or the teres major may be inhibited and shortened, which decreases this range performed within the upper extremity.

Next, check the internal range of the arm. Move the arm passively into internal rotation. The normal range is 70° to 90° with any limitations perhaps coming from dysfunctions in either or both the subscapularis or teres minor muscles. We also note for any ‘hard end feel’ which may indicate bony issues which means we would do further joint assessments.

internal rotation, internal range of the arm should be between 70 and 90° degrees- Chapsman Reflexes Blog Image

Performing Muscle Energy Treatment (MET) Shoulder

Move their forearm into an external rotation to perform MET. It is important that you stop at the first point where you feel restriction of the tissues. This is called Point of Bind and is at this length of the tissues that we get optimum results. They contract back towards internal rotation at 40% of the effort and no more; it is an isometric contraction where you are stabilizing the wrist and elbow to keep the joints motionless. This contraction is held for approximately 7 to 10 seconds. Ask your patient to take a deep cleansing breath and as they exhale they stop applying pressure of the muscle contraction. Keep in mind that it's important that their arm doesn't move. You will still be holding the wrist and elbow through the entire procedure and finding a new point of bind after each of the post-contraction relaxation phases.

Post-contraction Relaxation Phase

This time called Post-contraction Relaxation is when the tissues that had been contracting relax even further. We stay in limb ‘stiffness’ for up to 90 seconds and in this time the muscles relax even further so that we find the new passive end range or apply our new point of bind. Ask the patient to apply the contraction into internal rotation, still at 30% to 40% of their effort. This contraction again should be a minimum of 7 - 10 seconds. We get them to take cleansing breaths on each exhalation to improve the parasympathetic effect on the tissues; they can relax their muscle contraction as they breathe out.

Important Notes

Do the technique 3 times to see the most effective changes. Tell them to take a deep cleansing breath and that they relax the muscle contractions as they exhale. We reassess the ROM of external rotation after the third contraction and relaxation phase and we should see greater evidence of improved length through that range of motion.

This is a gentle technique for patients that feel pain and/or for those with issues in their range of motion. You might not want to use this treatment when there's a bony block when you test out the ranges. Be aware that if there's a joint restriction, we'd apply a mobilization technique or we'll adjust something deeper into that joint capsule.

Related Article: Best Pain-Free Subscapularis Massage for Shoulder Pain

Watch this Video

Here's the most effective video where you can see how to do this Muscle Energy Technique. It's a simple yet effective way to address the restrictions created by hypertonic internal rotators and gives more balance to their external rotator counterparts! Watch to go through these steps so you can practice from your clinic and also what homecare you can offer your patients when they are not in your practice.

References

Athwal, G. S. (2017, March). Rotator Cuff Tears. American Academy of Orthopaedic Surgeons. Retrieved February 20, 2022, from https://orthoinfo.aaos.org/en/diseases--conditions/rotator-cuff-tears-frequently-asked-questions/

Maruvada, S., Madrazo-Ibarra, A., & Varacallo, M. (2021, May 8). Anatomy, Rotator Cuff - StatPearls. NCBI. Retrieved February 20, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK441844/

Blog-Banner-Glenohumeral-Treatment-Techniques-for-Shoulder-Pain-and-Problems
joint pain shoulder injury shoulder pain
April 9, 2022 Paula Nutting

Myotherapy: Glenohumeral Joint Pain Treatment

Patients can come in with pain and stiffness from the neck that can refer to and causes elbow wrist and shoulder pain- acromioclavicular (AC) joint and the glenohumeral (GH) joint. Typically, it impedes movements such as lifting of the arms, brushing the teeth, or holding a golf club. It may be described as a moderate pain or a chronic pain that could affect sleep especially if it’s the shoulder you sleep on.

Shoulder Anatomy

You can help them by applying a variety of techniques to relieve uncomfortable pain or sensations in and around that area. But first, let's understand the shoulder anatomy. Since it is one of the most unstable joints in the body with the most movement, it can be complex to understand its structure and functionality.

Shoulder Structure and the three kind of bones, glenohumeral joint- Chapmans Reflexes Blog Image

The two shoulder joints that are prone to injury are the acromioclavicular (AC) joint and the glenohumeral (GH) joint. 

  • The acromioclavicular joint is situated where the clavicle is in contact with the acromion and the scapula. 
  • The glenohumeral joint is where the socket of the scapula connects with the rounded head of the humerus. It is responsible for the wide range of motion of the shoulder including flexion, extension, internal and external rotation, adduction and abduction and circumduction. 

There are  eight muscles attached to the bones of the shoulder. They are responsible for the form we see of the shoulder and underarm, they aid in its range of movement, and help protect the GH joint which is the main primary joint involved in function.

The deltoid muscle, which you may also know as the deltoideus muscle, is the shoulder muscle considered to be the largest and responsible for stabilization of the shoulder joint for the prevention of dislocations. 

The other muscles which work with the deltoid for shoulder movement and its functions include:

  • Infraspinatus - for arm raise and lowering
  • Triceps brachii - arm straightening
  • Pectoralis major - connects to the sternum
  • Pectoralis minor - stabilizes the scapula
  • Teres major - arm rotation 
  • Biceps brachii - rotates the forearm; flexes the elbow
  • Latissimus dorsi - helps with arm rotation and movement away from and close to the body
  • Subscapularis - aids to rotate the humerus 
  • Supraspinatus - help to raise arm away from the body

Shoulder Pains and Problems

Muscle Energy Technique

When any of the aforementioned muscles become dysfunctional, inhibited and reduced in their passive resting length, they tend to pull the humerus forward. According to OrthoInfo, shoulder problems that patients can experience fall into these categories:

  • Tendon inflammation - can be bursitis or tendinitis
  • Shoulder Instability - stretched lining of the shoulder joint, labrum, or ligaments 
  • Arthritis - joint tenderness and swelling
  • Fracture - can be caused by trauma or injury from a fall, sports activities, vehicular accident, or a direct hit to the shoulder

Other causes for shoulder pain that are less common include infections, tumors, and nerve related problems.

See Related Video: Shoulder Pathologies: Different Causes and Cool Tubing Treatments

In this article, we are going to focus on glenohumeral joint pain and an amazing muscle energy technique that could improve the humerus’s resting position. This will improve the quality and range of motion and reduce the notable pain felt by your patient. 

Almost any joint in the body can be safely treated with these techniques. Many sportsmen utilize them to avoid future muscle and joint injuries. It's primarily used by people who have restricted range of motion in their neck and back due to facet joint dysfunction found in the neck and back, for those who have broader issues like shoulder pain, sciatica, scoliosis, unsymmetrical legs, hips, or arms, and to treat chronic muscle pain, stiffness, or injury.

See Related Video: BEST exercises for the majority of shoulder problems using the water

Conducting the Assessment

You can clearly see how  far forward the humerus of the patient is. To conduct the test, ask them to be seated comfortably. Stand behind the patient and place your hand over their shoulder. Press your thumb into the tissue, as is in the picture below, until you can palpate the humerus. Note how far forward the humerus is, you can apply a second finger along with your thumb for a more clearer view.

Conducting the assessment for shoulder pain, glenohumeral joint and problems-Chapmans Reflexes Blog Image

Upon confirming that the humerus is anteriorized and checking if any symptoms of pain locally, and/or radiating up in the neck down to the elbow and wrists are present, you can go ahead with this simple muscle energy technique that will improve length of restricted tissue and bring the humerus back into the glenohumeral joint.

Related article: Shoulder Pathologies: Different Causes and Cool Tubing Treatments

Treatment

Let’s begin with the treatment steps. Here’s what you can do:

  1. Have your patient lie on their back (supine).
  2. Put your four fingers behind the humerus while your thumb and wrist sits on top of the humerus.
  3. Slide your thumb down until you get into a firm position.
  4. Push the top end of the humerus down, letting it press onto the table. At the same time, let your other hand elevate the elbow. Continue to do this seesaw-like motion that gently moves the humerus in the capsule a couple of times. Since it can be quite tender, remember not to apply too much force. 
  5. Apply gentle pressure until you can feel the bony end range and ask the patient to push their elbow to the floor and hold it for about 10 seconds. 
  6. Let the patient take a deep breath and when they release their breath you reduce the pressure applied to the limb whilst ensuring that the joint remains in an isometric position. 
  7. Repeat steps four to seven: You apply a rhythmic rocking back and forth motion of the humerus within the joint space for approximately 30 - 45 seconds or until it has a softer feel on the movement, it will start to have a smoother end feel. Continue with the gentle push while the patient takes a deep breath. When they breathe out, stop applying pressure as a counterforce on their humerus. When you apply the muscle energy technique, here are several tips to remember. When pushing down gently, hold it for about 10 seconds and ask the patient to exert 30% to 40% of their effort. Let them take a deep cleansing breath in and when they breathe out, that's when they stop contracting. You can do this three times before reassessing the joint position again. This should make headway into better movement patterns and reduced myofascial pain of the shoulder and surrounding compromised structures.

Watch This Video

Here's a short video where you can see how the steps are carried out. Watch to learn more how to follow through with the muscle energy technique. Try it from your clinic and you will see positive changes in your patients pain and function.

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